1
|
Rajalekshmi R, Agrawal DK. Energizing Healing with Electromagnetic Field Therapy in Musculoskeletal Disorders. JOURNAL OF ORTHOPAEDICS AND SPORTS MEDICINE 2024; 6:89-106. [PMID: 39036742 PMCID: PMC11258965 DOI: 10.26502/josm.511500147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 07/23/2024]
Abstract
There is mounting evidence to suggest that exogenous electromagnetic fields (EMF) may play a significant role in various biological processes that are crucial to therapeutic interventions. EMFs have been identified as a non-invasive, safe, and effective therapy that appears to have no apparent side effects. Numerous studies have demonstrated that pulsed EMFs (PEMFs) have the potential to become a stand-alone or adjunctive treatment modality for managing musculoskeletal disorders. However, several questions remain unresolved. Before their widespread clinical application, further research from well-designed, high-quality studies is required to standardize treatment parameters and determine the optimal protocol for healthcare decision-making. This article provides a comprehensive overview of the impact of musculoskeletal diseases on overall well-being, the limitations of conventional treatments, and the need to explore alternative therapeutic modalities such as electromagnetic field (EMF) therapy. EMF therapy uses low-frequency electromagnetic waves to stimulate tissue repair, reduce inflammation, and modulate pain signals, making it a safe and convenient alternative to conventional treatments. The article also discusses the historical perspective of EMF therapy in medicine. The article highlights the potential of EMF therapy as a personalized and comprehensive care option for musculoskeletal diseases, either alone or in conjunction with other therapies. It emphasizes the imperative for further research in this field and presents a compelling case for the use of EMF therapy in managing musculoskeletal diseases. Overall, the available findings on the underlying cellular and molecular biology support the use of EMF therapy as a viable option for the management of musculoskeletal disorders and stresses the need for continued research in this area.
Collapse
Affiliation(s)
- Resmi Rajalekshmi
- Department of Translational Research, College of the Osteopathic Medicine of the Pacific, Western University of Health Sciences, Pomona, California USA
| | - Devendra K Agrawal
- Department of Translational Research, College of the Osteopathic Medicine of the Pacific, Western University of Health Sciences, Pomona, California USA
| |
Collapse
|
2
|
ZHOU M, DONG Z, WEI C, FENG L, WANG X, LIU H, JI X, YANG K, LI S. Efficacy and safety of extracorporeal shock wave therapy combined with sodium hyaluronate in treatment of knee osteoarthritis: a systematic review and Meta-analysis. J TRADIT CHIN MED 2024; 44:243-250. [PMID: 38504530 PMCID: PMC10927402 DOI: 10.19852/j.cnki.jtcm.20231226.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 01/18/2023] [Indexed: 03/21/2024]
Abstract
OBJECTIVE To assess the efficacy and safety of extracorporeal shockwave therapy (ESWT) combined with sodium hyaluronate (HA) for the treatment of knee osteoarthritis (KOA). METHODS PubMed, Embase, the Cochrane Library, Web of Science, China National Knowledge Infrastructure, Wanfang database, China Science and Technology Journal Database, and SinoMed were searched from inception to July 2020. The quality of the randomized controlled trials was evaluated independently by two reviewers according to the criteria in the Cochrane Collaboration for Systematic Reviews. The identified articles were then screened individually using EndnoteX9 for eligibility in this Meta-analysis. The heterogeneity among the articles was evaluated using I2. RESULTS A total of 17 studies, comprising 2000 individuals, were included in this Meta-analysis. The results showed that a significant improvement was observed in knee pain and function based on the clinical efficacy of ESWT combined with HA. Statistical analysis of clinical efficacy showed that [relative risk (RR) = 1.21, 95% confidence interval (CI) (1.12, 1.30), P < 0.01]. Statistical analysis of visual analog scale showed that [standardized mean difference (SMD) = -2.84, 95%CI (-4.01, -1.66), P < 0.01]. Western Ontario and McMaster University osteoarthritis index statistical analysis showed that [SMD = -1.57, 95% CI (-2.52, -0.61), P < 0.01]. Lysholm score statistical analysis showed that [SMD = 1.71, 95% CI (0.98, 2.44), P < 0.01]. In addition, only minor side effects, such as redness and swelling of the skin, were observed. CONCLUSIONS Medium to low quality evidence showed that ESWT combined with HA offers an inexpensive, well-tolerated, safe, and effective method to improve pain and functionality in patients with KOA. However, tightly controlled, randomized, large multicenter trials are warranted to validate the current findings.
Collapse
Affiliation(s)
- Mingwang ZHOU
- 1 Department of Orthopaedics, Gansu Provincial Hospital of Traditional Chinese Medicine, Lanzhou 730050, China
| | - Zhuanli DONG
- 2 Department of Quality Management, Lanzhou Petrochemical General Hospital, Lanzhou 730050, China
| | - Changhao WEI
- 3 Department of Orthopaedics, Lanzhou Petrochemical General Hospital, Lanzhou 730050, China
| | - Lufang FENG
- 4 Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, 730000, China
- 5 Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China
- 6 Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou 730000, China
| | - Xiaoping WANG
- 7 Center for Translational Medicine, Gansu Provincial Hospital of Traditional Chinese Medicine, Lanzhou 730050, China
| | - Haiping LIU
- 7 Center for Translational Medicine, Gansu Provincial Hospital of Traditional Chinese Medicine, Lanzhou 730050, China
| | - Xing JI
- 7 Center for Translational Medicine, Gansu Provincial Hospital of Traditional Chinese Medicine, Lanzhou 730050, China
| | - Kehu YANG
- 4 Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, 730000, China
- 5 Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China
- 6 Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou 730000, China
| | - Shenghua LI
- 8 Department of Orthopaedics, Gansu Provincial Hospital of Traditional Chinese Medicine, Lanzhou 730000, China
| |
Collapse
|
3
|
Fu S, Lan Y, Wang G, Bao D, Qin B, Zheng Q, Liu H, Wong VKW. External stimulation: A potential therapeutic strategy for tendon-bone healing. Front Bioeng Biotechnol 2023; 11:1150290. [PMID: 37064229 PMCID: PMC10102526 DOI: 10.3389/fbioe.2023.1150290] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 03/23/2023] [Indexed: 04/03/2023] Open
Abstract
Injuries at the tendon-bone interface are very common in the field of sports medicine, and healing at the tendon-bone interface is complex. Injuries to the tendon-bone interface can seriously affect a patient’s quality of life, so it is essential to restore stability and promote healing of the tendon-bone interface. In addition to surgical treatment, the healing of tendons and bones can also be properly combined with extracorporeal stimulation therapy during the recovery process. In this review, we discuss the effects of extracorporeal shock waves (ESWs), low-intensity pulsed ultrasound (LIPUS), and mechanical stress on tendon-bone healing, focusing on the possible mechanisms of action of mechanical stress on tendon-bone healing in terms of transcription factors and biomolecules. The aim is to provide possible therapeutic approaches for subsequent clinical treatment.
Collapse
Affiliation(s)
- Shijie Fu
- Faculty of Chinese Medicine, Macau University of Science and Technology, Taipa, Macao SAR, China
- Department of Orthopedics, Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, Sichuan, China
- Dr. Neher’s Biophysics Laboratory for Innovative Drug Discovery, State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Taipa, Macao SAR, China
| | - Yujian Lan
- Department of Orthopedics, Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Guoyou Wang
- Department of Orthopedics, Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Dingsu Bao
- Department of Orthopedics, Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Bo Qin
- Department of Orthopedics, Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Qiu Zheng
- Department of Orthopedics, Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Huan Liu
- Department of Orthopedics, Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, Sichuan, China
- *Correspondence: Huan Liu, ; Vincent Kam Wai Wong,
| | - Vincent Kam Wai Wong
- Dr. Neher’s Biophysics Laboratory for Innovative Drug Discovery, State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Taipa, Macao SAR, China
- *Correspondence: Huan Liu, ; Vincent Kam Wai Wong,
| |
Collapse
|
4
|
Deng J, Zong Z, Su Z, Chen H, Huang J, Niu Y, Zhong H, Wei B. Recent Advances in Pharmacological Intervention of Osteoarthritis: A Biological Aspect. Front Pharmacol 2021; 12:772678. [PMID: 34887766 PMCID: PMC8649959 DOI: 10.3389/fphar.2021.772678] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 10/04/2021] [Indexed: 12/27/2022] Open
Abstract
Osteoarthritis (OA) is a degenerative joint disease in the musculoskeletal system with a relatively high incidence and disability rate in the elderly. It is characterized by the degradation of articular cartilage, inflammation of the synovial membrane, and abnormal structure in the periarticular and subchondral bones. Although progress has been made in uncovering the molecular mechanism, the etiology of OA is still complicated and unclear. Nevertheless, there is no treatment method that can effectively prevent or reverse the deterioration of cartilage and bone structure. In recent years, in the field of pharmacology, research focus has shifted to disease prevention and early treatment rather than disease modification in OA. Biologic agents become more and more attractive as their direct or indirect intervention effects on the initiation or development of OA. In this review, we will discuss a wide spectrum of biologic agents ranging from DNA, noncoding RNA, exosome, platelet-rich plasma (PRP), to protein. We searched for key words such as OA, DNA, gene, RNA, exosome, PRP, protein, and so on. From the pharmacological aspect, stem cell therapy is a very special technique, which is not included in this review. The literatures ranging from January 2016 to August 2021 were included and summarized. In this review, we aim to help readers have a complete and precise understanding of the current pharmacological research progress in the intervention of OA from the biological aspect and provide an indication for the future translational studies.
Collapse
Affiliation(s)
- Jinxia Deng
- Affiliated Hospital of Guangdong Medical University, Guangdong Medical University, Zhanjiang, China
| | - Zhixian Zong
- Affiliated Hospital of Guangdong Medical University, Guangdong Medical University, Zhanjiang, China
| | - Zhanpeng Su
- Affiliated Hospital of Guangdong Medical University, Guangdong Medical University, Zhanjiang, China
| | - Haicong Chen
- Affiliated Hospital of Guangdong Medical University, Guangdong Medical University, Zhanjiang, China
| | - Jianping Huang
- College of Dentistry, Yonsei University, Seoul, South Korea.,Department of Stomatology, Guangdong Medical University, Zhanjiang, China
| | - Yanru Niu
- Affiliated Hospital of Guangdong Medical University, Guangdong Medical University, Zhanjiang, China
| | - Huan Zhong
- Affiliated Hospital of Guangdong Medical University, Guangdong Medical University, Zhanjiang, China
| | - Bo Wei
- Affiliated Hospital of Guangdong Medical University, Guangdong Medical University, Zhanjiang, China
| |
Collapse
|
5
|
Mittermayr R, Haffner N, Feichtinger X, Schaden W. The role of shockwaves in the enhancement of bone repair - from basic principles to clinical application. Injury 2021; 52 Suppl 2:S84-S90. [PMID: 33714550 DOI: 10.1016/j.injury.2021.02.081] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 02/19/2021] [Accepted: 02/22/2021] [Indexed: 02/02/2023]
Abstract
Extracorporeal shockwave therapy is a treatment modality, originally introduced into the clinic as lithotripsie, which has also been successfully used in the last two decades in the non-invasive treatment of delayed or non-healing fractures. Initially, the mechanism of action was attributed to microfracture-induced repair, but intensive basic research has now shown that the shockwave generates its effect in tissue via mechanotransduction. Numerous signal transduction pathways have already been demonstrated, which in their entirety trigger an endogenous regeneration process via cell proliferation, migration and differentiation. Clinically, these shockwave-conveyed biological signals support healing of acute, delayed and non-union fractures. The attainable outcome is comparable to surgery but avoiding an open approach with associated potential complications. These advantageous properties with a clearly positive cost-benefit ratio make shockwave therapy a first line treatment in delayed and non-union fractures.
Collapse
Affiliation(s)
- Rainer Mittermayr
- Ludwig Boltzmann Institute for experimental and clinical traumatology, Vienna, Austria; AUVA Trauma Center Meidling, Vienna, Austria; AUVA trauma research center, Vienna, Austria; Austrian Cluster for Tissue Engineering, Vienna, Austria.
| | - Nicolas Haffner
- Ludwig Boltzmann Institute for experimental and clinical traumatology, Vienna, Austria; Clinic Floridsdorf, Orthopedic and Traumatology Department, Vienna, Austria
| | | | - Wolfgang Schaden
- Ludwig Boltzmann Institute for experimental and clinical traumatology, Vienna, Austria; AUVA trauma research center, Vienna, Austria; Austrian Cluster for Tissue Engineering, Vienna, Austria; AUVA Medical Board, Vienna, Austria
| |
Collapse
|
6
|
Abstract
Extracorporeal shock wave therapy (ESWT) is a safe therapy and there are only a few side effects known (such as pain during ESWT and minor haematomata), but no severe complications are to be expected if it is performed as recommended. Contraindications are severe coagulopathy for high-energy ESWT, and ESWT with focus on the foetus or embryo and focus on severe infection. The effect mechanism of ESWT is still a component of diverse studies, but as far as we can summarize today, it is a similar process to a cascade triggered by mechano-transduction: mechanical energy causes changes in the cellular skeleton, which provokes a reaction of the cell core (for example release of mRNA) to influence diverse cell structures such as mitochondria, endoplasmic reticulum, intracellular vesicles, etc., so the enzymatic response leads to the improvement of the healing process. The usage of ESWT should be taught, to improve the outcome. Courses should be organized by national societies, since the legal framework conditions are different from one country to another. In this update the musculoskeletal indications are addressed (mainly bone and tendons): pseudoarthrosis, delayed fracture healing, bone marrow oedema and osteonecrosis in its early stages, insertional tendinopathies such as plantar fasciitis and Achilles tendon fasciitis, calcifying tendonitis of the rotator cuff, tennis elbow, and wound healing problems.
Cite this article: EFORT Open Rev 2020;5:584-592. DOI: 10.1302/2058-5241.5.190067
Collapse
Affiliation(s)
- Vinzenz Auersperg
- Department of Orthopaedics, Klinikum Steyr-Kirchdorf, Steyr, Austria
| | - Klemens Trieb
- Department of Orthopaedic and Trauma Surgery, Paracelsus Medical University Salzburg, Salzburg, Austria.,Computed Tomography Research Group, University of Applied Sciences Upper Austria, Wels, Austria
| |
Collapse
|
7
|
Wang Y, Fan X, Xing L, Tian F. Wnt signaling: a promising target for osteoarthritis therapy. Cell Commun Signal 2019; 17:97. [PMID: 31420042 PMCID: PMC6697957 DOI: 10.1186/s12964-019-0411-x] [Citation(s) in RCA: 117] [Impact Index Per Article: 23.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 08/05/2019] [Indexed: 02/07/2023] Open
Abstract
Osteoarthritis (OA) is the most common joint disease worldwide and a leading cause of disability. Characterized by degradation of articular cartilage, synovial inflammation, and changes in periarticular and subchondral bone, OA can negatively impact an individual's physical and mental well-being. Recent studies have reported several critical signaling pathways as key regulators and activators of cellular and molecular processes during OA development. Wnt signaling is one such pathway whose signaling molecules and regulators were shown to be abnormally activated or suppressed. As such, agonists and antagonists of those molecules are potential candidates for OA treatment. Notably, a recent phase I clinical trial (NCT02095548) demonstrated the potential of SM04690, a small-molecule inhibitor of the Wnt signaling pathway, as a disease-modifying oseoarthritis drug (DMOAD). This review summarizes the role and mechanism of Wnt signaling and related molecules in regulating OA progression, with a view to accelerating the translation of such evidence into the development of strategies for OA treatment, particularly with respect to potential applications of molecules targeting the Wnt signaling pathway.
Collapse
Affiliation(s)
- Yudan Wang
- Medical Research Center, North China University of Science and Technology, Bohai Road 21, Caofeidian Dis, Tangshan, Hebei 063210 People’s Republic of China
| | - Xinhao Fan
- Department of Stomatology, Kailuan General Hospital, Tangshan, Hebei 063000 People’s Republic of China
| | - Lei Xing
- Department of Geriatrics, Affiliated hospital of North China University of Science and Technology, Jianshe South Road 57, Tangshan, Hebei 063000 People’s Republic of China
| | - Faming Tian
- Medical Research Center, North China University of Science and Technology, Bohai Road 21, Caofeidian Dis, Tangshan, Hebei 063210 People’s Republic of China
| |
Collapse
|
8
|
Allen MJ. What's New in Musculoskeletal Basic Science. J Bone Joint Surg Am 2018; 100:2082-2086. [PMID: 30516632 DOI: 10.2106/jbjs.18.01055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- Matthew J Allen
- Department of Veterinary Medicine, Surgical Discovery Centre, University of Cambridge, Cambridge, United Kingdom
| |
Collapse
|